Healthcare Provider Details

I. General information

NPI: 1932166188
Provider Name (Legal Business Name): MARISA A ROWLSON CNMW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/28/2006
Last Update Date: 04/29/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3401 CIVIC CENTER BLVD CHILDRENS HOSPITAL OF PHILADELPHIA
PHILADELPHIA PA
19104-4319
US

IV. Provider business mailing address

3401 CIVIC CENTER BLVD CHILDRENS HOSPITAL OF PHILADELPHIA
PHILADELPHIA PA
19104-4319
US

V. Phone/Fax

Practice location:
  • Phone: 215-590-1000
  • Fax:
Mailing address:
  • Phone: 215-590-1000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License Number057514-23
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: